COMMUNITY RESOURCE NAVIGATOR - WELLNESS WEST

Cook County Health; Illinois; On-site; USD 34,000 - 45,000; Full time

Benefits offered by this job

Medical, Dental, Vision Coverage

Pension Plan

Paid Holidays

Vacation and Sick Time

PSLF eligibility

Job summary

Cook County Health is seeking a Community Resource Navigator to support care coordination for members in home, clinic, and hospital settings. The role focuses on navigating the health system, reducing barriers, and advocating for patients under the supervision of CBSWCC.

The grant-funded position ends 12-31-2026 and requires health risk screenings, member education, referrals, and thorough documentation in the care management system. Travel to member sites is expected.

Qualifications

• High School Diploma or GED required.
• One year in health care or community-based social services with health risk screenings or education.
• Valid Illinois driver’s license and vehicle insurance required.
• One year of experience with software and computers (data entry, scheduling).
• Bachelor’s degree preferred for advancement.

Responsibilities

• Complete health risk screenings and document responses.
• Educate members to maximize benefits and appropriate care.
• Schedule appointments, process referrals, and follow up to close care gaps.
• Assist with program referrals (DRS/DOA/HDM) and send confirmations.
• Link members to community resources via CBSWCC guidance.
• Travel to members’ homes or care sites for outreach and follow-up.
• Document activities in Care Management System per policy.
• Protect PHI and comply with privacy policy.

Skills

Health risk screenings

Care coordination

Education delivery

Patient advocacy

Outreach

PHI protection

Documentation

Interdisciplinary collaboration

Education

High School Diploma or GED

Bachelor’s degree preferred

Tools

Microsoft Outlook

Care Management System

Care portals (Passport/Managed Care)

Job description

Job Summary AFSCME 1111

The Community Resource Navigator (CRN) works under the supervision to support the provision of care coordination services for members who are community based. These services are offered at the patient’s home, physician office, and/or hospital stay throughout the County of Cook. The CRN helps the members navigate the health care delivery system, advocates on their behalf and works to reduce barriers that interfere with the member’s ability to successfully interface with their medical home provider.

This is a grant-funded position, grant end date 12-31-2026

• Completes health risk screenings by asking the members questions and documenting the response.
• Provides education to members on ways to increase the benefits of health system interaction, i.e., call before medications run out, call medical home prior to going to the Emergency Department (ED) for non-life-threatening issues, being prepared for provider visits.
• Performs supportive tasks for members such as scheduling appointments, referrals to community-based resources and directions on how to access services and care, follows up with the member to close gaps in care.
• Receives referrals to assist members in completing applications, i.e., Department of Rehabilitation Services (DRS), Department of Aging (DOA), Home Delivered Meals (HDM), etc., mail/email the member the confirmation to support coordination of care by case management that will follow.
• Works under direction of Community Based Social Work Care Coordinator (CBSWCC) to link members to appropriate programs.
• Supports efforts to locate members, i.e., completing the Unable to Reach (UTR) process when necessary. This may include calling medical homes, pharmacies, driving by last known address to place outreach materials, conduct online search using white pages, contacting healthcare providers for updated demographic information, etc.
• Utilizes health risk screenings to determine escalation to licensed clinical staff as determined by Care Coordination policy.
• Calls patient discharged from ED to screen for improvement in symptoms and engagement of ED treatment plan such as prescriptions filled, appointments made. Refers cases to Community Based Nurse Care Coordinator (CBNCC) for non-improvement in symptoms and incomplete after-care.
• Interfaces with payers to validate authorization for required services.
• Completes all education activities/training as required by state or accreditation standards. Attends training and receives certification to support patient education, i.e., diabetic education.
• Provides lay education to members on self-management for chronic conditions consistent with CRN role. Coordinates care with CBNCC or CBSWCC to elevate issues needing immediate attention.
• Participates in Interdisciplinary Rounds as requested.
• Documents all activities in the Care Management System according to Care Management policy and procedure.
• Retrieves documentation from outside care organization such as history and physical, discharge summaries, and medication list to support effective transitions of care.
• Travels to the homes of members and their sites of patient care to perform outreach and follow-up on care.
• Protects Protected Health Information (PHI) and complies with Cook County Health Privacy Policy.
• Consults information systems such as passport, managed care portals or care management systems to assess member eligibility for service.
• Performs other duties as assigned.

Job Title

Community Resource Navigator

Department

Cook County Health

SHIFT

8:30AM-4:30PM

$28.917 STARTING HOURLY

Summary

The Community Resource Navigator (CRN) works under the supervision to support the provision of care coordination services for members who are community based. These services are offered at the patient’s home, physician office, and/or hospital stay throughout the County of Cook. The CRN helps the members navigate the health care delivery system, advocates on their behalf and works to reduce barriers that interfere with the member’s ability to successfully interface with their medical home provider.

This is a grant-funded position, grant end date 12-31-2026

Typical Duties

• Completes health risk screenings by asking the members questions and documenting the response.
• Provides education to members on ways to increase the benefits of health system interaction, i.e., call before medications run out, call medical home prior to going to the Emergency Department (ED) for non-life-threatening issues, being prepared for provider visits.
• Performs supportive tasks for members such as scheduling appointments, referrals to community-based resources and directions on how to access services and care, follows up with the member to close gaps in care.
• Receives referrals to assist members in completing applications, i.e., Department of Rehabilitation Services (DRS), Department of Aging (DOA), Home Delivered Meals (HDM), etc., mail/email the member the confirmation to support coordination of care by case management that will follow.
• Works under direction of Community Based Social Work Care Coordinator (CBSWCC) to link members to appropriate programs.
• Supports efforts to locate members, i.e., completing the Unable to Reach (UTR) process when necessary. This may include calling medical homes, pharmacies, driving by last known address to place outreach materials, conduct online search using white pages, contacting healthcare providers for updated demographic information, etc.
• Utilizes health risk screenings to determine escalation to licensed clinical staff as determined by Care Coordination policy.
• Calls patient discharged from ED to screen for improvement in symptoms and engagement of ED treatment plan such as prescriptions filled, appointments made. Refers cases to Community Based Nurse Care Coordinator (CBNCC) for non-improvement in symptoms and incomplete after-care.
• Interfaces with payers to validate authorization for required services.
• Completes all education activities/training as required by state or accreditation standards. Attends training and receives certification to support patient education, i.e., diabetic education.
• Provides lay education to members on self-management for chronic conditions consistent with CRN role. Coordinates care with CBNCC or CBSWCC to elevate issues needing immediate attention.
• Participates in Interdisciplinary Rounds as requested.
• Documents all activities in the Care Management System according to Care Management policy and procedure.
• Retrieves documentation from outside care organization such as history and physical, discharge summaries, and medication list to support effective transitions of care.
• Travels to the homes of members and their sites of patient care to perform outreach and follow-up on care.
• Protects Protected Health Information (PHI) and complies with Cook County Health Privacy Policy.
• Consults information systems such as passport, managed care portals or care management systems to assess member eligibility for service.
• Performs other duties as assigned.

Minimum Qualifications

• High School Diploma or GED is required (Must provide proof at time of interview)
• One (1) year of experience in a health care organization or community based social service agency performing health risk screenings, providing health education or supporting linkages to community-based resources is required
• Valid Illinois Driver’s license and mandatory vehicle insurance as required in the State of Illinois (Must provide proof at time of interview)
• One (1) year of experience with software and computers, i.e., data entry, word processing, appointment scheduling, Microsoft Office is require

Preferred Qualifications

• Bachelor’s degree from an accredited college or university is preferred (Must provide official transcripts at time of interview)
• Graduate of a Community Health Worker (CHW) Program is preferred

Knowledge, Skills, Abilities And Other Characteristics

• Excellent verbal and written communication skills necessary to communicate with all levels of staff and a patient population composed of diverse cultures and age groups
• Ability to track meetings, appointments, and emails in Microsoft Outlook
• Ability to effectively prioritize work
• Ability to meet deadlines

Physical and Environmental Demands

This position is functioning within a healthcare environment. The incumbent is responsible for adherence to all hospital and department specific safety requirements. This includes but is not limited to the following policies and procedures: complying with Personal Protective Equipment requirements, hand washing and sanitizing practices, complying with department specific engineering and work practice controls and any other work area safety precautions as specified by hospital wide policy and departmental procedures.

VETERAN PREFERENCE

When applying for employment with the Cook County Health & Hospitals System, preference is given to honorably discharged Veterans who have served in the Armed Forces of the United States for not less than 6 months of continuous service.

• Meet the minimum qualifications for the position.
• Identify self as a Veteran on the employment application by answering yes to the question by answering yes to the question, "Are you a Military Veteran?"
• Attach a copy of their DD 214, DD 215 or NGB 22 (Notice of Separation at time of application filing. Please note: If you have multiple DD214s, 215s, or NGB 22S, Please submit the one with the latest date. Coast Guard must submit a certified copy of the military separation from either the Department of Transportation (Before 9/11) or the Department of Homeland Security (After 9/11). Discharge papers must list and Honorable Discharge Status. Discharge papers not listing an Honorable Discharge Status are not acceptable

OR

A copy of a valid State ID Card or Driver’s License which identifies the holder of the ID as a Veteran, may also be attached to the application at time of filing.

If items are not attached, you will not be eligible for Veteran Preference

VETERANS MUST PROVIDE ORIGINAL APPLICABLE DISCHARGE PAPERS OR APPLICABLE STATE ID CARD OR DRIVER’S LICENSE AT TIME OF INTERVIEW.

Benefits Package

• Medical, Dental, and Vision Coverage
• Basic Term Life Insurance
• Pension Plan
• Deferred Compensation Program
• Paid Holidays, Vacation, and Sick Time
• You may also qualify for the Public Service Loan Forgiveness Program (PSLF)

For further information on our excellent benefits package, please click on the following link: http://www.cookcountyrisk.com/

Must Meet Required Qualifications At Time Of Application

Degrees awarded outside of the United States with the exception of those awarded in one of the United States' territories and Canada must be credentialed by an approved U.S. credential evaluation service belonging to the National Association of Credential Evaluation Services (NACES) or the Association of International Credential Evaluators (AICE). Original credentialing documents must be presented at time of interview.

• Please note all offers of Employment are contingent upon the following conditions: satisfactory professional & employment references, healthcare and criminal background checks, appropriate licensure/certifications and the successful completion of a physical and pre-employment drug screen.
• CCHHS is strictly prohibited from conditioning, basing or knowingly prejudicing or affecting any term or aspect of County employment or hiring upon or because of any political reason or factor.

COOK COUNTY HEALTH IS AN EQUAL OPPORTUNITY EMPLOYER.